Emad M Ammar, DDS
Individual provider Active NPI Periodontics · Glendora, CA
NPI 1104091255 · NPPES record last updated Apr 29, 2008
Key facts
- NPI
- 1104091255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Periodontics 1223P0300X
- License
- 39127 (CA)
- Practice address
- 175 N Pennsylvania Ave
Ste #5
Glendora, CA 91741 - Phone
- (626) 335-6888
- Fax
- (626) 335-0277
- NPI assigned
- Apr 29, 2008
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39127 | CA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 39127 | CA | Yes |
Addresses
Primary practice location
175 N Pennsylvania Ave
Ste #5
Glendora, CA 91741
Mailing address
175 N Pennsylvania Ave
Ste #5
Glendora, CA 91741
Phone (626) 335-6888
Other providers in Glendora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.